Individual
JERRY JEFFREY WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1827 DIXON RD, GASTONIA, NC 28054-5801
(704) 864-3681
(704) 864-3643
Mailing address
1207 S BELVEDERE AVE, GASTONIA, NC 28054-5102
(704) 864-3681
(704) 864-3643
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4742
NC
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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